Coding Clinic Response:
I have also run into this situation. I found this coding clinic regarding deep vs superficial lymph node biopsy/excision:
Jan 2009 CPT Assistant: Question: What is the most appropriate code to report a simple, deep lymph node excision of the inguinal area (not a radical lymphadenectomy)?
Answer: From a CPT coding perspective, code 38760, Inguinofemoral lymphadenectomy, superficial, including Cloquets node (separate procedure), represents a procedure for a superficial dissection of the inguinal lymph nodes (groin nodes) and is commonly performed for malignancy. Code 38765, Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure), represents the work described by code 38760 plus a deep dissection of the pelvic lymph nodes on the same side as the superficial dissection. If a full dissection is not performed (regardless of depth or regions), depending on the technique used, either code 38500, Biopsy or excision of lymph node(s); open, superficial, or code 38505, Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary), is reportable.